cardiac tamppnade.pptx
- 2. objectives
- 3. What is Cardiac Tamponade? It is a condition in which fluid is accumulated in pericardial sac. It exerts very high pressure that it obstructs the inflow of blood into the heart Eventually,cardiac filling is compromised,cardiac output will drop and the patient becomes hemodynamically unstable.
- 5. What is pericardium Double walled sac Contains heart and roots of great vessels Pericardial sac has 2 layers
- 6. The pericardial sac contains upto 30-50ml of fluid It can hold 80-200ml of fluid acutely and even upto 2L if the fluid accumulates slowly Functions- -sets heart in mediastinum and limits its motion -protects it from infectious coming from other organs(such as lungs) -prevents excessive dilation of the heart in cases of acute volume overload -lubricates the heart
- 8. Factors The mechanism and development of cardiac tamponade mainly depend upon following factors: Amount of fluid Rapidity with which fluid is accumulated Compliance of pericardium. If pericardium is very stiff, then small amount of fluid can produce the tamponade.
- 9. 1. Acute cardiac tamponade (rapid fluid accumulation 100-200 ml) Causes: 1. Chest trauma leading to rupture the free wall of the heart. 2. Post MI 3. Aortic dissection 2. Subacute/Chronic cardiac tamponade (slow accumulation of fluid, upto 2000ml fluid) Causes: 1.Neoplasia 2. TB
- 10. Chest trauma leading to rupture the free wall of the heart. Aortic dissection
- 11. Neoplasia TB
- 13. Trauma and wounds to the heart
- 14. Pericarditis
- 17. Uremia
- 18. Lung cancer
- 19. Breast cancer
- 20. HIV infection
- 21. Physiology
- 22. SIGNS & SYMPTOMS Chest pain Breathing difficulty
- 23. Pulsus paradoxus
- 24. Elevated jugular venous pressure
- 26. Palpitations
- 27. Hypotension
- 28. Anxiety
- 29. restlessness
- 30. Swelling of abdomen or other organs
- 31. Investigation RFT ESR Mantoux test HIV Testing
- 32. Diagnosis Echo cardiogram Ct scan or MRI of chest Chest X-ray ECG
- 33. Management Cardiac tamponade is a medical emergency that requires a urgent drainage of the pericardial fluid Pt. with this condition should monitor in ICU . Oxygen . bed rest should be given with leg elevation . volume expansion to maintain adequate intravascular volume .special inotropic drug must be given ie, dobutamine
- 34. Pericardiocentesis Surgical drainage Pericardial plueral fistula pericardidectomy
- 35. Physical Assessment Neuro : confusion, anxiety Resp : Trachypnea CV : Muffled heart tones, JVD, Paradoxical pulse, decreased peripheral pulse, delayed capillary refill G.U : decreased urine output
- 36. Vital signs RR : increased HR : increased BP : Low; paradox present TEMP : normal CVP/PAWP: increased CO : decreased SVR : increased
- 37. NURSING DIAGNOSIS Decreased urine output related to reduced ventricular filling secondary to increased intrapericardial pressure Ineffective tissue perfusion related to interruption of arterial blood flow Impaired gas exchange related to ineffective breathing pattern